Notifiable Disease

History

To prevent the introduction and subsequent spread of cholera, smallpox, plague, and yellow fever in the United States, in 1887 the Congress authorized the U.S. Marine Hospital Service, now the Public Health Service (PHS), to collect case data from overseas consuls. The collection of information on these first four notifiable diseases was expanded to include cases in the Unites States in 1893. Until the 1950s, state and territorial health authorities worked with the PHS to designate additional notifiable diseases. The first annual summary of notifiable disease, published in 1912, included reports from 19 states, the District of Columbia, and Hawaii for 10 infectious diseases.

By 1928, 29 diseases were being reported by all states, the District of Columbia, Hawaii, and Puerto Rico. In 1951, the CSTE was formed and became responsible for designating diseases to be included in the NNDSS. That year, 41 infectious diseases were nationally notifiable.

Traditionally, notifiable diseases were infectious diseases. However, in 1995 the first noninfectious condition, elevated blood-lead levels, was added to the NNDSS. The following year the first risk factor, cigarette smoking, was added. In 2006, more than 60 diseases and conditions were nationally notifiable.

Local, National, and International Notifiable Diseases

While CSTE suggests nationally notifiable diseases, it does not have the authority to require states’ participation in the NNDSS. Within its jurisdictions, states and territories have the authority to designate which diseases must be reported. Based on the needs and resources of each region, local notifiable diseases lists may exclude diseases included in the NNDSS and include diseases not surveilled nationally. Notifiable disease lists are not static; diseases are added or removed based on current public health needs. Notifiable diseases may be classified on the urgency of reporting and assigned varying time requirements. Generally, physicians and diagnostic laboratories are responsible for reporting cases to local health authorities who, in additional to immediate control and prevention activities, report cases to the state health departments.

All states and territories are required to report cases of cholera, plague, yellow fever, and other quarantinable diseases of international concern. Internationally reportable diseases are dictated by the International Health Regulations set forth by the World Health Organization.